Individual
JAMIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 TWELVE OAKS DR, HARDY, VA 24101-5633
(540) 287-2568
Mailing address
3070 PARHAM DR, ROANOKE, VA 24014-5352
(540) 204-3544
(540) 204-3544
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-65069
VA
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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